| Background:Lower respiratory tract infection is a common and serious disease that threat to human health,and is a major issue affecting public health. Due to many factors, for example air pollution, population aging, smoking, the morbidity and mortality of lower respiratory tract infection to society caused enormous economic burden. Videography and biochemical tests for the diagnosis of lower respiratory tract infection have a high specificity. But Videography can’t distinguish the pathogens, In terms of treatment, early clear pathogens and giving the corresponding drug therapy according to the pathogen is crucial. Pathogen detection include sputum culture,bronchoalveolar lavage fluid culture,pleural effusion culture, blood culture, etc. Because of its long incubation time of pathogens, often lags behind clinical, so empiric drug treatment especially important for critical ill patients. Understanding the pathogen distribution and drug resistance of lower respiratory tract infection in our department will help clinicians use proper medication. Through counting and analyzing the pathogens and drug susceptibility results of the lower respiratory tract infection patients from January 2013 to December 2014 in respiratory department,it will help to guide clinicians rational use drug.Objective:To investigate the distribution and antimicrobial resistance of pathogens from the patients who were diagnosed as lower respiratory tract infection in the respiratory department of our hospital, in order to provide better guidance for the clinical application of antibiotics.Methods:Analyzed the culture results and drug sensitivity of sputum, alveolar lavage fluid, pleural effusion and blood,which collected from the patients who were diagnosed as lower respiratory tract infection in the respiratory department of our hospital during Jan 2013 to Dec 2014.Results:The total specimen detection rate of Lower respiratory tract infection was72.3%, and the detection rate in the general ward of Respiratory was69.8%, ICU detection rate was 96.7%. Totally 566 strains of pathogen were isolated, including gram-negative bacteria, accounting for 63.4%,gram-positive bacteria,accounting for 8.0%, and fungi, accounting for28.6%. The top of the gram-negative bacteria was Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii,Stenotrophomonas maltophilia, Enterobacter cloacae, Escherichia coli.The majority of Gram-positive bacteria was Staphylococcus aureus. The majority of Fungus was canidia Albicans. The gram-negative bacteria were sensitive to cefoperazone sulbactam, piperacillin- tazobactam,arbapenems, amikacin and tigecycline, while gram-negative bacteria had high drug resistance to the first, second and third generation cephalosporins and semi-synthetic penicillin. The resistant rate of Pseudomonas aeruginosa to the first, second and third generation cephalosporins, ampicillin, ampicillin-Sulbactam were above 90%, the resistantrate to cefotaxime was 52%. Pseudomonas aeruginosa has good sensitivity to the fourth generation cephalosporin, penicillium carbon alkene, ciprofloxacin and levofloxacin, and the sensitive rate above 70%.The drug resistance rates of Acinetobacter baumannii to most drugs were more than 50%. Klebsiella pneumoniae had good sensitivity to most antibiotics. The resistant rate of Enterobacter cloacae to first, second and third generation cephalosporins was more than 50%. The resistant rate of Escherichia coli to cefuroxime sodium, cefazolin, ampicillin,ciprofloxacin, cefotaxime was more than 50%. The drug resistance rates of gram-positive bacteria to most drugs were more than 50%. The tigecycline-, vancomycin-, or linezolid-resistant pathogens strains have not been detected. There was 19 strains of ESBLs detected.The resistant rate of Klebsiella pneumoniae producing ESBLs to most antibiotics were higher than non-producing ESBLs strains.Conclusion:Infection caused by Gram-negative bacteria is predominant in the pathogens which caused lower respiratory tract infection, and drug resistance is also different. The physician should understand local pathogenic bacteria distribution and drug resistance timely, in order to guide the empirical use of drugs. There was 19 strains of ESBLs detected.The resistant rate of Klebsiella pneumoniae producing ESBLs to most antibiotics were higher than non-producing ESBLs strains. |
